Ingestion of a foreign body can be a life-threating event. This is the case if the foreign body blocks the airway and leads to suffocation and quick death of the patient.
Other objects that do not block the airway still can interfere with the transport of matter along the digestive tract and might block the passage of food with subsequent complications. Foreign body ingestion in children, moreover, is a common problem, with coins being the most commonly ingested.
With the modern age and an increasing number of battery-operated toys and controls in the household, another complication can arise: the ingestion of a battery. With increasing accessibility to electronic toys and devices by children, however, more batteries have been swallowed and affected children required medical attention by pediatricians and pediatric otolaryngologists (Marom et al., 2010). In many cases, the batteries pass the upper gastrointestinal tract and are eliminated in the stool after a few days.
This is different in small children such as young children, toddlers and infants, however, especially for those who are too young to adequately inform a parent or treating physician concerning the nature of what the child may have ingested. Batteries with a 12 mm or larger diameter can become impacted in the esophagus and an electrical current can form around the outside of the battery. This generates hydroxide and cause serious internal injuries, tissue damage, chemical burns, and even death (Marom et al., 2010). An example of the burning effects of a battery are shown in FIG. 1. In rare cases, ensuing damage may include esophageal or an aortic perforation, tracheo-esophageal fistula, severe esophageal bleeding, vocal cord paralysis, and heavy metal poisoning or intoxication.
A study by Litovitz et al. (2010) summarizes the most important trend in 2010. The authors examined data from, the (1) National Poison Data System (56535 cases, 1985-2009), (2) the National Battery Ingestion Hotline (8648 cases, July 1990-September 2008) and (3) the medical literature and the National Battery Ingestion Hotline cases (13 deaths and 73 major outcomes). All sources showed worsening outcomes, with a 6.7-fold increase in the percentage of button battery ingestions with major or fatal outcomes from 1985 to 2009 (National Poison Data System). The ingestions of 20- to 25-mm-diameter cells increased from 1% to 18% of ingested button batteries (1990-2008). This is similar to the rise in ingestion of lithium cell batteries (1.3% to 24%). The reported outcomes were significantly worse when the batteries were large-diameter lithium cell batteries (≥20 mm) and the children were younger than 4 years old. The 20-mm lithium cell batteries were implicated in the most severe outcomes. Severe burns with sequelae occurred in just 2 to 2.5 hours. Most fatal (92%) or major outcome (56%) ingestions were not witnessed. At least 27% of major outcome and 54% of fatal cases were misdiagnosed, usually because of nonspecific presentations. Injuries may also continue after removal of the battery, with unanticipated and delayed esophageal perforations, tracheoesophageal fistulas, fistulization into major vessels, and massive hemorrhage.
Typical prior art procedures to be followed for a patient with foreign body ingestion is shown in FIGS. 2-4. FIG. 2 illustrates a typical foreign body evaluation worksheet. It should be noted that high-risk scenarios include button batteries located in the esophagus, lead objects located in the stomach, and magnets and metal objects located in the stomach and beyond. Since batteries may cause severe damage (including death of a child) in under two to 2.5 hours, it is extremely important that any ingested battery be identified as such very early in the medical examination process.
In case that a battery has been ingested, another diagnostic and treatment worksheet is typically followed, as illustrated in the flow chart of FIG. 3. It should be noted that impacted button batteries in the esophagus of children is an emergency. The therapeutic procedure is the removal of the battery with rigid esophaguscopy or bronchoscopy. Additional treatments may also be provided following the removal of the battery.
Similarly to ingestion of batteries, ingestion of magnets creates an emergency situation as well. A diagnostic and treatment worksheet exists for magnetic ingestion, as illustrated in the flow chart of FIG. 4. Many magnets are made of materials which are toxic. In addition, in the event more than one magnet is ingested, or ingested along with other ferromagnetic or magnetic objects such as pins or coins, the multiple magnets and/or other objects may clamp around tissue in the gastrointestinal (GI) tract, causing myriad problems such as puncture wounds, other perforations, or impactions, also requiring immediate removal of the magnet(s). All of these situations may also be life threatening and/or may significantly increase the duration of hospitalization of a child, resulting in increased healthcare costs.
In addition to ingestion of a battery or a magnet by a child, batteries or magnets may also be ingested by a pet, such as a pet dog or cat, resulting in a veterinary emergency, with similar procedures utilized to diagnose and treat the affected animal.
X-ray imaging is often utilized to determine if an ingested object is a battery, a coin, or another object. Moreover, several x-rays may have to be taken to clearly distinguish between a battery and a non-battery foreign body. In many instances, however, x-ray imaging cannot discriminate between objects such as button batteries or coins. For example, a button battery cannot be distinguished from a coin in an x-ray image when a double shadow or “halo” sign of a battery is not discernable in the image. An example of an x-ray image allowing the identification of a button battery is shown in FIG. 5, which shows the double shadow or halo 30 of a button battery 50. In many cases, moreover, especially as button batteries become increasingly thinner, and a double shadow or halo may not be discernable in imaging. In addition, in circumstances or locations which do not have an x-ray machine readily available, and/or available within a comparatively short window of time, an ingested foreign body cannot be identified as a battery, magnet or coin. In other cases it is not possible to immediately take an x-ray, such as in a physician office or at the child's home.
Accordingly, it is extremely important to identify an ingested foreign object as a battery or a magnet to appropriately treat the child or pet and to minimize side effects that can result from battery or magnet ingestion, such as the severe burning from a battery illustrated in FIG. 1.
Accordingly, there is an ongoing need for new apparatuses, methods and/or systems for noninvasive and accurate detection of an ingested battery or magnet. Such an apparatus, method and/or system should be comparatively unobtrusive, portable, convenient and easy to use for a treating physician, a nurse, a technician, other medical personnel, or an individual consumer, while nonetheless being comparatively or sufficiently accurate to obtain meaningful results and actionable information, and with a comparatively fast detection time.